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Clinical transplantation: current problems, possible solutions.

Roy Calne1

  • 1Department of Surgery, Addenbrooke's Hospital, Cambridge, UK. cpr1000@cam.ac.uk

Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
|September 9, 2005
PubMed
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Organ transplantation has seen remarkable success, with over 90% graft function at one year and long-term survival rates. The primary challenge remains a critical shortage of organ donors, impacting future advancements.

Area of Science:

  • Medical Science
  • Surgical Innovation
  • Immunology

Background:

  • Review of organ transplantation progress over 50 years since the first identical twin transplant.
  • Highlighting the significant advancements and successes in the field.

Observation:

  • Current patient survival rates post-operation exceed expectations.
  • Graft function at one year is over 90%, with graft half-life extending beyond 10 years.
  • Long-term survival into the fifth decade for kidney and fourth decade for liver transplants has been achieved.

Findings:

  • The primary obstacle to further progress in organ transplantation is the persistent shortage of organ donors.
  • Increased donations from living volunteers are noted, alongside concerns regarding unethical and illegal practices.

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Implications:

  • Future advancements include more effective, less toxic immunosuppression and induction therapy potentially leading to transplant tolerance.
  • Cell transplantation is anticipated for clinical use within 5-10 years.
  • Xenotransplantation (animal-to-human) remains a significant challenge with uncertain near-future clinical success.